ABSTRACT
OBJECTIVE: To compare the effect of a single 5-mg dose of pilocarpine hydrochloride on the salivary flow rate in three groups of xerostomic patients. SUBJECTS AND METHODS: Forty-five patients were divided into three groups according to the etiology of their xerostomia: (i) radiotherapy; (ii) Sjögren's syndrome; and (iii) sialosis and xerogenic medications. Following the oral administration of a 5-mg pilocarpine hydrochloride tablet blood pressure, heart rate, body temperature and saliva secretion rates were monitored hourly for 3 h and adverse events were reported. RESULTS: The most significant and persistent elevation of salivary flow rate was observed in the sialosis/drug-induced group followed by the Sjögren's syndrome group. The radiotherapy group presented a significant elevation of salivary secretion rate after 1 and 2 h, but returned to baseline at 3 h. No significant changes in vital signs were reported, except for low diastolic pressure measured at 1 h in the radiotherapy group. Several adverse events were recorded throughout the trial; however, only one patient withdrew from the study. CONCLUSION: Treatment with pilocarpine hydrochloride tablets may improve saliva secretion in patients taking xerogenic medications and/or suffering from metabolic sialosis expanding the beneficial potential of this sialogogue.
Subject(s)
Muscarinic Agonists/therapeutic use , Pilocarpine/therapeutic use , Xerostomia/drug therapy , Adult , Aged , Aged, 80 and over , Blood Pressure/drug effects , Body Temperature/drug effects , Cohort Studies , Dizziness/chemically induced , Drug-Related Side Effects and Adverse Reactions , Female , Follow-Up Studies , Heart Rate/drug effects , Humans , Male , Middle Aged , Muscarinic Agonists/administration & dosage , Muscarinic Agonists/adverse effects , Pilocarpine/administration & dosage , Pilocarpine/adverse effects , Radiotherapy/adverse effects , Saliva/drug effects , Saliva/metabolism , Secretory Rate/drug effects , Sialadenitis/complications , Sjogren's Syndrome/complications , Sweating/drug effects , Urination/drug effects , Xerostomia/etiologyABSTRACT
OBJECTIVES: To study the effect of single-dose pilocarpine hydrochloride 5 mg on the whole unstimulated and stimulated salivary flow in patients suffering from thyroid cancer treated with radioiodine therapy, and to investigate the changes in vital signs during the treatment. SUBJECTS AND METHODS: Five such patients were referred with complaints of dry mouth, rampant caries, and pain in the parotid gland region or history of chronic recurrent suppurative sialodenitis. A single dose of 5 mg pilocarpine hydrochloride was administered to each patient and blood pressure, heart rate, body temperature and salivary secretion rate were monitored at 1, 2 and 3 h. RESULTS: A significant elevation of unstimulated and stimulated saliva flow rate was observed in four patients without significant alteration of the monitored vital signs. CONCLUSIONS: Treatment with pilocarpine hydrochloride may be beneficial in the case of impaired salivary function in patients treated with radioiodine.
Subject(s)
Iodine Radioisotopes/adverse effects , Muscarinic Agonists/therapeutic use , Parotid Diseases/drug therapy , Pilocarpine/therapeutic use , Sialadenitis/drug therapy , Thyroid Neoplasms/radiotherapy , Adult , Aged , Blood Pressure , Body Temperature , Chronic Disease , Dental Caries/etiology , Female , Heart Rate , Humans , Male , Middle Aged , Muscarinic Agonists/pharmacology , Parotid Diseases/etiology , Parotid Diseases/physiopathology , Pilocarpine/pharmacology , Saliva/metabolism , Secretory Rate/drug effects , Secretory Rate/radiation effects , Sialadenitis/etiology , Sialadenitis/physiopathology , Statistics, Nonparametric , Xerostomia/etiologyABSTRACT
The sense of taste has great importance in health and disease. Complaints of oral discomfort associated with taste disturbances are increasingly met in the clinical setting. Altered taste perception can result from various underlying local or systemic pathology, as well as serious sensorial syndromes. Although they are not straightforward to diagnose and manage, it is important for the clinician to understand the pathphysiology of this chemosensory system, and to be able to use objective measures in order to quantify and classify the apparent symptoms, thus making the first step to correct diagnosis and treatment.
